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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013423060
Report Date: 11/29/2021
Date Signed: 11/29/2021 01:58:39 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/30/2021 and conducted by Evaluator Arminder Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210830110437
FACILITY NAME:SMALL SIZE BIG MIND INCFACILITY NUMBER:
013423060
ADMINISTRATOR:CHOP, MALYKAFACILITY TYPE:
850
ADDRESS:2450 PAN AM WAYTELEPHONE:
(510) 420-4567
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:114CENSUS: 70DATE:
11/29/2021
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Malyka ChopTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child sustained injuries while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/29/2021 LPA Singh met with Administrator Malyka Chop, to provide the results of the above allegation. It was alleged that Day care child sustained injuries while in care.
LPA Singh conducted interviews with Administrator, Staff, and Parents. The child was pushed by another child during play time. The staff checked for injuries but did not notice anything at that time.

Based on the investigative findings although the allegation may have happened or be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time.

The facility was provided a copy of the appeal rights. An exit interview was conducted with Administrator, a copy of the complaint investigation report was provided and Notice of Site was issued.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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